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Neurorehabilitation and Neural Repair Oct 2023We aimed to identify key aspects of the learning dynamics of proprioception training including: 1) specificity to the training type, 2) acquisition of proprioceptive... (Review)
Review
OBJECTIVE
We aimed to identify key aspects of the learning dynamics of proprioception training including: 1) specificity to the training type, 2) acquisition of proprioceptive skills, 3) retention of learning effects, and 4) transfer to different proprioceptive skills.
METHODS
We performed a systematic literature search using the database (MEDLINE, EMBASE, Cochrane Library, and PEDro). The inclusion criteria required adult participants who underwent any training program that could enhance proprioceptive function, and at least 1 quantitative assessment of proprioception before and after the intervention. We analyzed within-group changes to quantify the effectiveness of an intervention.
RESULTS
In total, 106 studies with 343 participant-outcome groups were included. Proprioception-specific training resulted in large effect sizes with a mean improvement of 23.4 to 42.6%, nonspecific training resulted in medium effect sizes with 12.3 to 22% improvement, and no training resulted in small effect sizes with 5.0 to 8.9% improvement. Single-session training exhibited significant proprioceptive improvement immediately (10 studies). For training interventions with a midway evaluation (4 studies), trained groups improved by approximately 70% of their final value at the midway point. Proprioceptive improvements were largely maintained at a delayed follow-up of at least 1 week (12 studies). Finally, improvements in 1 assessment were significantly correlated with improvements in another assessment (10 studies).
CONCLUSIONS
Proprioceptive learning appears to exhibit several features similar to motor learning, including specificity to the training type, 2 time constant learning curves, good retention, and improvements that are correlated between different assessments, suggesting a possible, common mechanism for the transfer of training.
Topics: Adult; Humans; Proprioception; Learning
PubMed: 37864458
DOI: 10.1177/15459683231207354 -
Physical Therapy Jun 2016Despite common use of proprioceptive retraining interventions in people with chronic, idiopathic neck pain, evidence that proprioceptive dysfunction exists in this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Despite common use of proprioceptive retraining interventions in people with chronic, idiopathic neck pain, evidence that proprioceptive dysfunction exists in this population is lacking. Determining whether proprioceptive dysfunction exists in people with chronic neck pain has clear implications for treatment prescription.
PURPOSE
The aim of this study was to synthesize and critically appraise all evidence evaluating proprioceptive dysfunction in people with chronic, idiopathic neck pain by completing a systematic review and meta-analysis.
DATA SOURCES
MEDLINE, CINAHL, PubMed, Allied and Complementary Medicine, EMBASE, Academic Search Premier, Scopus, Physiotherapy Evidence Database (PEDro), and Cochrane Collaboration databases were searched.
STUDY SELECTION
All published studies that compared neck proprioception (joint position sense) between a chronic, idiopathic neck pain sample and asymptomatic controls were included.
DATA EXTRACTION
Two independent reviewers extracted relevant population and proprioception data and assessed methodological quality using a modified Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
DATA SYNTHESIS
Thirteen studies were included in the present review. Meta-analysis on 10 studies demonstrated that people with chronic neck pain perform significantly worse on head-to-neutral repositioning tests, with a moderate standardized mean difference of 0.44 (95% confidence interval=0.25, 0.63). Two studies evaluated head repositioning using trunk movement (no active head movement thus hypothesized to remove vestibular input) and showed conflicting results. Three studies evaluated complex or postural repositioning tests; postural repositioning was no different between groups, and complex movement tests were impaired only in participants with chronic neck pain if error was continuously evaluated throughout the movement.
LIMITATIONS
A paucity of studies evaluating complex or postural repositioning tests does not permit any solid conclusions about them.
CONCLUSIONS
People with chronic, idiopathic neck pain are worse than asymptomatic controls at head-to-neutral repositioning tests.
Topics: Chronic Pain; Head; Humans; Neck Pain; Posture; Proprioception; Somatosensory Disorders
PubMed: 26472296
DOI: 10.2522/ptj.20150241 -
Child: Care, Health and Development Nov 2016Somatosensory modalities, such as touch, proprioception and haptic ability, greatly influence the achievement of developmental milestones for children. Describing... (Review)
Review
BACKGROUND
Somatosensory modalities, such as touch, proprioception and haptic ability, greatly influence the achievement of developmental milestones for children. Describing somatosensory impairment, natural variability and typical or expected developmental changes across age groups will help establish frameworks for intervention in clinical populations. This systematic review aimed to determine how different somatosensory modalities develop across childhood into adolescence to use as a point of reference for children at risk of somatosensory impairment.
METHODS
Searches of five electronic databases were undertaken through EBSCO-host (MEDLINE, CINAHL, PsycINFO, SPORTDiscus and ERIC) for studies measuring at least one somatosensory modality in typically developing individuals between birth and 18 years and analysed by age. Characteristics of studies were collected including country of origin, sample size, demographics and outcome measure used. Quality assessment and data extraction were performed by two independent reviewers.
RESULTS
Twenty three cross-sectional studies were included from a total of 188 articles retrieved: 8 examined aspects of touch, 5 proprioception and 10 haptic ability. Variability of study designs and variation in assessment tools precluded any formal meta-analysis.
CONCLUSIONS
Somatosensation matures through childhood into adolescence; however, the present review found the pattern of somatosensory development varied depending on the assessment tool used and the aspect of somatosensation being measured, making it difficult to describe typical performance. There is a need for comprehensive assessment batteries to measure the somatosensation, including touch, proprioception and haptic ability, of children at risk of somatosensory impairment to aid in the development of effective interventions.
Topics: Adolescent; Adolescent Development; Aging; Child; Child Development; Humans; Proprioception; Psychomotor Performance; Reference Values; Stereognosis; Touch Perception
PubMed: 27470009
DOI: 10.1111/cch.12375 -
Archives of Physical Medicine and... Apr 2023To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To conduct a comprehensive systematic review and meta-analysis of the effects of active video game (AVG) interventions on postural balance across all ages in populations with and without neurologic impairments, using all types of platforms.
DATA SOURCE
Six databases (PubMed, PsycINFO, Sport Discus, MEDLINE, Web of Science, and Google Scholar) were reviewed by December 31, 2020.
STUDY SELECTION
The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, a study must be original, published in English peer-reviewed venues and employed AVGs as the sole or primary intervention to enhance, maintain, or regain postural balance. At least 2 within- or between-subjects conditions must be included with ≥10 participants per condition.
DATA EXTRACTION
Three reviewers independently performed data extraction and assessed the risk of bias.
DATA SYNTHESIS
129 studies were identified, with 102 eligible for meta-analysis. The total number of tested participants was 6407 (60.0% women, M=55.1 years, range=3-99 years, SD=22.6). The average intervention duration was 35.6 min/session with 3.1 sessions/week for 7.6 weeks. The overall effect favored AVG interventions (Hedges' g=0.469; 95% confidence interval [CI]=0.407-0.531). Although the overall study quality was relatively low, the analysis expectedly indicated significantly larger effects (P<.001) for AVG-interventions over passive controls (Hedges' g=0.627; 95% CI=0.466-0.788), but importantly also favored AVG-interventions over conventional treatment (Hedges' g=0.389; 95% CI=0.311-0.468). All clinical populations responded positively, although with different effect sizes (P=.023). Children experienced larger treatment effects (Hedges' g=0.550; 95% CI=0.336-0.764), closely followed by seniors (Hedges' g=0.529; 95% CI=0.402-0.656). The largest intervention effect on balance improvements was seen in healthy people without a medical condition (Hedges' g=0.609; 95% CI=0.465-0.753).
CONCLUSIONS
AVGs can produce postural balance improvements and better postural maintenance. All populations could benefit from AVG interventions.
Topics: Child; Humans; Female; Male; Sports; Postural Balance; Video Games; Health Status
PubMed: 36669637
DOI: 10.1016/j.apmr.2023.01.002 -
The Journal of Arthroplasty Mar 2024Extended reality (XR), including virtual reality, augmented reality, and mixed reality, has been increasingly used in postoperative rehabilitation of total knee... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Extended reality (XR), including virtual reality, augmented reality, and mixed reality, has been increasingly used in postoperative rehabilitation of total knee arthroplasty (TKA). The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of XR-based rehabilitation in TKA compared to conventional rehabilitation.
METHODS
In this study, we searched PubMed (MEDLINE), Embase (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and clinicaltrials.gov from inception to February 15, 2023 for eligible studies. A total of 14 randomized controlled trials with 989 patients were included in our study. The primary outcomes were pain and function. The secondary outcomes were anxiety and quality of life. A systematic review and meta-analysis was performed.
RESULTS
The pooled data indicated XR-based rehabilitation significantly improved the visual analog scale (standardized mean difference [SMD] = -0.31, 95% Confidence Interval [CI] [-0.47 to -0.15], P = .0001), the Western Ontario and McMaster Universities Osteoarthritis Index (SMD = -0.46, 95% CI [-0.86 to -0.06], P = .02), range of motion (SMD = 0.40, 95% CI [0.09 to 0.72], P = .01), and anxiety scores (mean difference = -3.95, 95% CI [-7.76 to -0.13], P = .04) than conventional rehabilitation, but Timed Up and Go test and quality of life were similar in the 2 groups.
CONCLUSION
This systematic review and meta-analysis found XR-based rehabilitation improved pain, function, and anxiety, but not quality of life in TKA compared to conventional rehabilitation within 1 month postoperatively. Based on the pooled results, we suggested that XR-based rehabilitation may have benefit in patients' postoperative rehabilitation in TKA.
Topics: Humans; Arthroplasty, Replacement, Knee; Augmented Reality; Quality of Life; Postural Balance; Time and Motion Studies; Pain, Postoperative; Randomized Controlled Trials as Topic
PubMed: 37598785
DOI: 10.1016/j.arth.2023.08.051 -
Perceptual and Motor Skills Jun 2022Considering that somatosensory impairments may impact motor performance in individuals with cerebral palsy (CP), a better understanding of these relations is relevant to...
Considering that somatosensory impairments may impact motor performance in individuals with cerebral palsy (CP), a better understanding of these relations is relevant to planning interventions. To synthesize research evidence to date on the interrelationships between the somatosensory functions of touch and proprioception with motor functions in persons with CP, we systematically searched Embase, CINAHL, PsycINFO, and Medline databases for studies relating these variables that were published in English from the inception of these databases to November 2020. We targeted the following content categories in our literature search: (a) cerebral palsy; (b) sensory functions; (c) tactile functions; (d) proprioception functions; and (e) motor functions. The selection, data extraction, and methodological quality assessment of these studies were performed in duplicate. We retrieved and analyzed information regarding the studies' methodological approaches and synthesized results. The 11 studies that met our inclusion criteria showed that, in individuals with CP, impairments in tactile discrimination, proprioception, and stereognosis are related to motor functions in terms of overall manual ability, grip strength, postural control and locomotion. Thus, clinical practitioners should attend to somatosensory aspects of motor impairment in individuals with CP. More research is needed to clarify the direction of these associations.
Topics: Cerebral Palsy; Humans; Motor Disorders; Proprioception; Touch; Touch Perception
PubMed: 35452588
DOI: 10.1177/00315125221093904 -
Sports Medicine (Auckland, N.Z.) Jan 2018Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary... (Review)
Review
BACKGROUND
Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary contributing factors. However, readers are now faced with several systematic reviews that present conflicting findings.
OBJECTIVE
The aim of this systematic review and meta-analysis was to establish the statistical significance and effect size of primary factors contributing to CAI and to identify likely reasons for inconsistencies in the literature.
METHODS
Relevant health databases were searched: CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus. Systematic reviews were included if they answered a focused research question, clearly defined the search strategy criteria and study selection/inclusion and completed a comprehensive search of the literature. Included reviews needed to be published in a peer-reviewed journal and needed to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis. There was no language restriction. Studies using a non-systematic review methodology (e.g. primary studies and narrative reviews) were excluded. Methodological quality of systematic reviews was assessed using the modified R-AMSTAR tool. Meta-analysis on included primary studies was performed.
RESULTS
Only 17% of primary studies measured a clearly defined CAI population. There is strong evidence to support the contribution of dynamic balance, peroneal reaction time and eversion strength deficits and moderate evidence for proprioception and static balance deficits to non-specific ankle instability.
CONCLUSIONS
Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits; however, these findings may not be translated to the CAI population. Research should be updated with an adequately controlled CAI population.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO 2016, CRD42016032592.
Topics: Ankle; Ankle Injuries; Ankle Joint; Humans; Joint Instability; Proprioception; Sprains and Strains
PubMed: 28887759
DOI: 10.1007/s40279-017-0781-4 -
Ageing Research Reviews Nov 2023This systematic review with meta-analyses investigates the impact of resistance training (RT), using meta-regressions, on functional performance in frail and pre-frail... (Meta-Analysis)
Meta-Analysis Review
Are dose-response relationships of resistance training reliable to improve functional performance in frail and pre-frail older adults? A systematic review with meta-analysis and meta-regression of randomized controlled trials.
This systematic review with meta-analyses investigates the impact of resistance training (RT), using meta-regressions, on functional performance in frail and pre-frail adults aged ≥ 65 years to determine the key variables of RT. Ten randomized controlled trials involving 1303 participants were analyzed. Five studies assessed habitual walking speed (HWS), three studies evaluated performance in the timed-up-and-go test (TUG), three studies evaluated performance in the Short Physical Performance Battery (SPPB), and three studies assessed performance in the sit-to-stand test (STS). RT alone improved STS time and SPPB scores in frail and pre-frail older adults. RT improved STS performance (Effect Size (ES):- 0.536; 95% CI - 0.874 to - 0.199; p = .002) and led to a 2.261-point increase in SPPB performance (ES:1.682; 95% CI 0.579-2.786; p = .003). At least two weekly training sessions are required to increase SPPB scores, and three sessions seem to optimize the improvements. Higher training volume per exercise and volume per session reduce the gains in SPPB performance. We did not observe any association between different doses of RT and STS time improvements. RT alone positively influenced TUG performance only in community-dwelling older frail and pre-frail adults but not in institutionalized older individuals. RT alone did not improve the HWS compared to the non-active control group.
Topics: Aged; Humans; Frail Elderly; Resistance Training; Postural Balance; Time and Motion Studies; Randomized Controlled Trials as Topic; Physical Functional Performance
PubMed: 37774931
DOI: 10.1016/j.arr.2023.102079 -
Archives of Orthopaedic and Trauma... Mar 2021Theoretically, proprioceptive acuity could decrease in patients with knee osteoarthritis. However, there have been conflicting results in terms of proprioceptive deficit... (Meta-Analysis)
Meta-Analysis
PURPOSE
Theoretically, proprioceptive acuity could decrease in patients with knee osteoarthritis. However, there have been conflicting results in terms of proprioceptive deficit in osteoarthritic knees. The purpose of this systematic review and meta-analysis was to compare knee proprioception between osteoarthritic and healthy control knees.
METHODS
Studies comparing proprioception in osteoarthritic and healthy knees of age-matched control group using thresholds to detect passive motion (TTDPM) or joint position sense (JPS) tests were identified. JPS was assessed by measuring the reproduction of passive positioning (RPP) or active positioning (RAP) of the knees.
RESULTS
Seventeen studies were finally included in this meta-analysis. The pooled results of the analyses of the TTDPM for both 30° and 45° knee flexion showed that the mean angle of error was 0.83° greater (95% confidence interval: 0.44 to 1.23°; p < 0.001) in the osteoarthritic knees than in control knees. The pooled data of the RAP and RPP also showed that the mean angle of error was 1.89° greater in the osteoarthritic knees than in the control group. The mean difference in the angle of error between the osteoarthritic knees and control group was 1.06° greater in the JPS test than in the TTDPM (p < 0.001).
CONCLUSION
The knee proprioceptive acuity of the patients with knee osteoarthritis was poorer than that of the patients with unaffected knees in the age-matched control group both in terms of the TTDPM and JPS; clinical relevance of these deficits needs to be clarified in further studies.
LEVEL OF EVIDENCE
Meta-analysis, Level II.
Topics: Humans; Knee Joint; Osteoarthritis, Knee; Proprioception; Range of Motion, Articular
PubMed: 32232620
DOI: 10.1007/s00402-020-03418-2 -
Journal of Hand Therapy : Official... 2020Proprioception encompasses the submodalities of joint position sense (JPS), kinesthesia, sense of force, and velocity. Owing to the vast mobility of the shoulder, it...
INTRODUCTION
Proprioception encompasses the submodalities of joint position sense (JPS), kinesthesia, sense of force, and velocity. Owing to the vast mobility of the shoulder, it heavily relies on an intact sense of proprioception. Moreover, shoulder injuries are associated with a decreased sense of proprioception. What remains unclear is how shoulder proprioception is affected by pain and competing nociceptive senses.
PURPOSE OF THE STUDY
To summarize the literature evaluating the relationship between pain and shoulder proprioception.
METHODS
A literature review was conducted from inception until 22 October 2018, using electronic databases (PubMed, Web of Science, Scopus, EBSCO, CINAHL, and Embase). Retrieved citations were screened for eligibility, and methodological quality was assessed using the Newcastle-Ottawa Scale (NOS).
RESULTS
Eleven studies were included (n = 447 participants with shoulder pain, n = 20 with experimentally induced pain [EIP]/n = 600 painful shoulders and n = 20 [EIP]). The mean methodological quality of the studies was good (76%). Five studies investigated active JPS, four investigated passive JPS, six investigated kinesthesia, sense of force was measured in one study, and no study investigated sense of velocity. There is moderate evidence for impaired kinesthesia and low evidence for reduced sense of force among painful shoulders. Conflicting evidence is seen for the other proprioceptive submodalities.
CONCLUSION
The overall impact of pain on shoulder JPS remains unclear, while moderate evidence for an affected sense of kinesthesia is possible. There is low evidence for an impaired sense of force among painful shoulders. Standardization between studies is lacking, limiting the range of our conclusions. Further investigation is required into well-controlled and pain-induced studies to better understand the influence of pain on shoulder proprioception.
Topics: Humans; Proprioception; Range of Motion, Articular; Shoulder Joint; Shoulder Pain
PubMed: 31481340
DOI: 10.1016/j.jht.2019.06.002